Bal Vidya Mandir - Registration
DISCIPLINE, DEVOTION, AND DEVELOPMENT OF CHARACTER
Child Information
First Name *
Your answer
Middle Name
Your answer
Last Name *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Age *
Your answer
Grade *
Your answer
Gender *
SIBLING(S)
Name
Your answer
Age
Your answer
Name
Your answer
Age
Your answer
PARENTS
Father *
Your answer
Home Phone *
Your answer
Cell Phone *
Your answer
Email Id *
Your answer
Mother *
Your answer
Home Phone *
Your answer
Cell Phone *
Your answer
Email Id *
Your answer
Address *
Your answer
City *
Your answer
State *
Your answer
ZIP Code *
Your answer
I would like to be a volunteer at Mandir *
Required
ALTERNATE CONTACT
Name *
Your answer
Relationship *
Your answer
Phone *
Your answer
Registration fee $100. Please use Online Pay or make checks payable to ‘Sai Samsthan USA’.
Parent Guidelines, I read and understood Bala Vidya Mandir parent guidelines. *
Bow to Sri Sai! Peace Be to All!!
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